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With all of the recent media coverage over whether Republicans will repeal and replace the Affordable Care Act (Obamacare), scant attention has been paid to the elephant in the room — namely, what would happen to the economy and health insurance market if Obamacare is not rolled back?

One likely outcome is that the Affordable Care Act’s complex regulations and taxes would continue to deter the growth of businesses, resulting in higher unemployment and a lower standard of living for many Americans.

For example, Obamacare penalizes companies that have 50 or more employees with steep fines if these businesses do not offer what it defines as “affordable” health insurance to their full-time workers. Because the law also changes the definition of “full-time” from 40 hours to 30 hours a week, many home health care companies, restaurants and other businesses with low profit margins have had to restructure their workforces and trim employees’ workweeks. All of this has led to fewer hours and smaller paychecks for many American workers.

Since the rules for complying with these and other Obamacare regulations are extremely complicated, large employers must also now spend countless hours every month tracking their employees’ work status (including whether they are full-time, part-time, seasonal, or have flex hours) and sending the required reports to the IRS. This is time that they could have spent focusing on how to grow and expand their businesses.

In addition, many business owners are concerned that if the Affordable Care Act is not rolled back, their companies will be hurt further by its taxes (some of which have been delayed), including taxes on high-cost health plans, medical devices, prescription drugs, and over-the-counter medications.

Labor unions are also worried about the Obamacare tax on expensive employee benefit plans (dubbed the “Cadillac Tax”), which has been postponed until 2020. The reason for their concern is that it may cause employers to choose cheaper health plans, resulting in workers having their current generous benefit plans replaced by much skimpier ones. (The Kaiser Family Foundation estimates that 30 percent of employers would be affected by this tax by 2023.)

Many more workers may also be faced with reduced benefits when the Department of Health & Human Services ends its transition policy, which has allowed small businesses to renew their pre-ACA health plans ever since 2014, if permitted by their states. This transition policy was recently extended for one more year, but when it finally ends, many employees may be shocked at the high deductibles and narrow provider networks in their new company plans. What’s more, their employers may be faced with starkly higher premiums.

As for private health insurance, hundreds of counties now have only one insurer on the Obamacare state exchanges, while Aetna and Humana have both announced they will be exiting all exchanges next year because of huge losses, and other carriers are threatening to do the same.

As a result, many people will find themselves with few, if any, choices. In addition, individual premiums are expected to rise again.

However noble the intentions behind Obamacare may have been, its unintended consequences have been very unfortunate — and the worst may be yet to come!

JERRY CALISTRI is president and chief executive officer of Swift Kennedy & Associates, an insurance brokerage and consulting firm specializing in group employee benefit plans, individual policies, and senior insurance needs, which has offices in Wilkes-Barre, State College, Williamsport, and DuBois. He can be reached at jerry@swiftkennedy.com.

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